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Exercise and Pregnancy, Dr. Berger’s Corner: Health Topics from the Medical Director of CHA Fertility Center, Los Angeles

December 18, 2017

Dr. Berger’s Corner: Health Topics from the Medical Director of CHA Fertility Center, Los Angeles

Exercise and pregnancy

Maintaining a regular exercise routine throughout your pregnancy can help you stay healthy and feel your best. Working-out can help improve your posture and decrease some common discomforts such as backaches and fatigue. If you were physically active before your pregnancy, you should be able to continue your level of activity but to a more moderate degree. As the pregnancy progresses, listen to your body and it will tell you how hard to go. For those of you that are very competitive, now is not the time to try and achieve personal records. Pregnancy is more of a time to maintain and prevent less of aerobic capabilities. Also, ultra-competitive athletes should be closely followed by an obstetrician.

If you have never exercised regularly before, you can safely begin an exercise program that is suited to your overall fitness level. Pregnancy s not the time to start a program with the sole intention of losing weight and getting in the best shape of one’s life. Low impact exercise regimens are the best, and these include walking, modified yoga, modified pilates, and swimming. High impact aerobics, sports that require sudden changes in direction, or those in which the abdomen may be directly hit are not recommended at all. Other activities such as jogging can be done in moderation, especially if you were doing them before your pregnancy. You may want to choose exercises or activities that do not require great balance or coordination, especially later in pregnancy.

The American College of Obstetrics and Gynecology recommends 30 minutes or more of moderate exercise per day on most if not all days of the week, unless you have a medical or pregnancy complication. Also, for those that use a heart rate monitor, it is best to stay at or below a pulse rate of 145 beats per minute. Do not stay above that level for prolonged periods of time.

Here are some basic exercise guidelines for pregnant women:

  • Wear loose fitting, comfortable clothes as well as a good support bra.
  • Choose shoes that are designed for the type of exercise you do. Proper shoes are your best protection against injury.
  • Consume enough calories to meet the needs of your pregnancy (300 more calories per day than before you were pregnant) as well as your exercise program.
  • Drink water before, during, and after your workout.
  • After doing floor exercises, get up slowly and gradually to prevent dizziness.
  • Never exercise to the point of exhaustion. If you cannot talk normally while exercising, you are probably over-exerting yourself and should slow down your activity.

If you have a medical problem, such as asthma, heart disease, or diabetes, exercise should be approached with caution and only with the approval of your obstetrician. Exercise may also be harmful if you have a pregnancy-related condition such as:

  • Bleeding or spotting
  • Low lying placenta
  • Threatened or recurrent miscarriage
  • Previous premature births or history of early labor
  • Weak cervix

Always talk with your provider before beginning an exercise program. They will be better able to give personal exercise guidelines, based on your medical history.

There are certain activities that can be harmful if performed during pregnancy. They include:

  • Holding your breath during any activity.
  • Activities where falling is likely (such as skiing and horseback riding).
  • Contact sports such as softball, football, basketball, and volleyball.
  • Any exercise that may cause even mild abdominal trauma such as activities that include jarring motions or rapid changes in direction.
  • Activities that require extensive jumping, hopping, skipping, bouncing, or running.
  • Deep knee bends, full sit-ups, double leg raises, and straight-leg toe touches.
  • Exercise in hot, humid conditions such as Bikram Yoga.

Just to be sure, I want to include some very important safety tips. Stop exercising and get some help if you:

  • Feel chest pain or are short of breath suddenly.
  • Have abdominal pain, pelvic pain, or persistent contractions.
  • Notice an absence or decrease in fetal movement.
  • Feel faint, dizzy, nauseous, or light-headed or feel cold and sweaty.
  • Have vaginal bleeding or have a sudden gush of fluid from the vagina or a trickle of fluid that leaks steadily.
  • Have sudden swelling in your ankles, hands, face, or calf pain.
  • Suddenly have difficulty walking or muscle weakness.

It is best to ask your physician when it is right for YOU to begin your exercise routine after delivering your baby. Although you may be eager to get in shape quickly, return to your pre-pregnancy fitness routines gradually. Be patient and follow those recommendations.

In general, most women can safely perform a low-impact activity one to two weeks after a vaginal birth (or three to four weeks after a cesarean birth). Do about half of your normal routine for the first week, and gradually increase back up to your prior level. Remember, it will take some time before you are accustomed to your body without a baby inside, and there will also be numerous changes especially to the bones of the pelvis and the bones in your feet. Go slow and avoid excess, those are the safest ways to avoid injuries!

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